Acute Effects of Rope Therapy (Vestibular Stimulation) on Heart Rate Variability Coherence in Taiwanese Social Workers: A Within-Subjects Pilot Study
Dr. Benny W. L. Lam （ Hong Kong Association of Professionals Specializing in Addiction Counseling (HKAPSAC) ）
Dr. Adrian Low Eng Ken （ Hong Kong Association of Psychology (HKAP) ）
Mr. Tony Chau （ Rope Therapy Association (RTA), Hong Kong ）
Mr. Marco Wong （ Rope Therapy Association (RTA), Hong Kong ）
https://doi.org/10.37155/2972-3086-0502-1Abstract
Background: Social workers represent a high-risk occupational group for chronic stress, burnout, and reduced autonomic regulation. Bottom-up, body-based interventions targeting vestibular-autonomic pathways may offer accessible alternatives to cognitive approaches; however, empirical evidence in helping professions remains limited.
Objective: To examine acute changes in heart rate variability (HRV) coherence following a single session of Rope Therapy (RT) — a structured vestibular stimulation intervention — in Taiwanese social workers reporting occupational stress and anxiety.
Methods: Thirteen Taiwanese social workers (12 female, 1 male; ages 25–42 years, M = 31.6, SD = 6.5) completed a single intervention session comprising a pre-intervention HRV measurement, a structured RT protocol involving graded rotational vestibular stimulation, and a post-intervention HRV measurement. HRV was recorded using the emWave Pro system (HeartMath Institute), with coherence score — an index of cardiorespiratory synchronization reflecting autonomic regulation — low/medium/high coherence ratios, and average heart rate as primary outcomes. Within-subjects analyses employed Wilcoxon signed-rank tests, with effect sizes reported as r.
Results & Conclusion: See full text.
Keywords
Heart rate variability; coherence; vestibular stimulation; rope therapy; social workers; occupational stress; autonomic regulation; trauma-informed practice; pilot studyFull Text
PDFReferences
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[36]Thayer, J. F., & Lane, R. D. (2009). Claude Bernard and the heart-brain connection: Further elaboration of a model of neurovisceral integration. Neuroscience & Biobehavioral Reviews, 33(2), 81–88.
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[38]Tsai, W. (2017). Cultural differences in emotion expression and suppression: Implications for health and well-being. Cultural Diversity and Ethnic Minority Psychology, 23(3), 405–418.
[39]Umetani, K., Singer, D. H., McCraty, R., & Atkinson, M. (1998). Twenty-four hour time domain heart rate variability and heart rate: Relations to age and gender over nine decades. Journal of the American College of Cardiology, 31(3), 593–601.
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[41]Wagaman, M. A., Geiger, J. M., Shockley, C., & Segal, E. A. (2015). The role of empathy in burnout, compassion satisfaction, and secondary traumatic stress among social workers. Social Work, 60(3), 201–209.
[42]Yates, B. J., & Bronstein, A. M. (2005). The effects of vestibular system lesions on autonomic regulation: Observations, mechanisms, and clinical implications. Journal of Vestibular Research, 15(3), 119–129.
[2]Balaban, C. D., & Thayer, J. F. (2001). Neurological bases for balance-anxiety links. Journal of Anxiety Disorders, 15(1–2), 53–79.
[3]Berntson, G. G., Cacioppo, J. T., & Quigley, K. S. (1991). Autonomic determinism: The modes of autonomic control, the doctrine of autonomic space, and the laws of autonomic constraint. Psychological Review, 98(4), 459–487.
[4]Berntson, G. G., & Cacioppo, J. T. (2007). Integrative physiology: Homeostasis, allostasis, and the orchestration of systemic physiology. In J. T. Cacioppo, L. G. Tassinary, & G. G. Berntson (Eds.), Handbook of psychophysiology (3rd ed., pp. 433–452). Cambridge University Press.
[5]Bradley, M. M., & Lang, P. J. (2007). Emotion and motivation. In J. T. Cacioppo, L. G. Tassinary, & G. G. Berntson (Eds.), Handbook of psychophysiology (3rd ed., pp. 581–607). Cambridge University Press.
[6]Bride, B. E. (2007). Prevalence of secondary traumatic stress among social workers. Social Work, 52(1), 63–70.
[7]Chalmers, J. A., Quintana, D. S., Abbott, M. J., & Kemp, A. H. (2014). Anxiety disorders are associated with reduced heart rate variability: A meta-analysis. Frontiers in Psychiatry, 5, 80.
[8]Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Lawrence Erlbaum Associates.
[9]Craig, A. D. (2002). How do you feel? Interoception: The sense of the physiological condition of the body. Nature Reviews Neuroscience, 3(8), 655–666.
[10]Critchley, H. D., Wiens, S., Rotshtein, P., Öhman, A., & Dolan, R. J. (2004). Neural systems supporting interoceptive awareness. Nature Neuroscience, 7(2), 189–195.
[11]Dana, D. (2018). The polyvagal theory in therapy: Engaging the rhythm of regulation. W. W. Norton.
[12]Friedman, B. H. (2007). An autonomic flexibility-neurovisceral integration model of anxiety and cardiac vagal tone. Biological Psychology, 74(2), 185–199.
[13]Goyal, M., Singh, S., Sibinga, E. M., Gould, N. F., Rowland-Seymour, A., Sharma, R., Berger, Z., Sleicher, D., Maron, D. D., Shihab, H. M., Ranasinghe, P. D., Linn, S., Saha, S., Bass, E. B., & Haythornthwaite, J. A. (2014). Meditation programs for psychological stress and well-being: A systematic review and meta-analysis. JAMA Internal Medicine, 174(3), 357–368.
[14]Koenig, J., & Thayer, J. F. (2016). Sex differences in healthy human heart rate variability: A meta-analysis. Neuroscience & Biobehavioral Reviews, 64, 288–310.
[15]Kim, H., & Stoner, M. (2008). Burnout and turnover intention among social workers: Effects of role stress, job autonomy and social support. Administration in Social Work, 32(3), 5–25.
[16]Laborde, S., Mosley, E., & Thayer, J. F. (2017). Heart rate variability and cardiac vagal tone in psychophysiological research—Recommendations for experiment planning, data analysis, and data reporting. Frontiers in Psychology, 8, 213.
[17]Lam, W. L., Chau, K. T., Wong, C. C., Low, A., Chan, M. H., Chung, C. C., Kwok, N. Y., & Tsang, L. K. (2024). Effects of home-based rope therapy on children with special educational needs. Applied Psychology Research, 3(1), 1281.
[18]Lam, B. W. L., Low, A. E. K., Wong, M. C. C., & Chau, T. (2025). Temperament and change: A pilot investigation of Rope Therapy (RT/BMAT) and Taylor-Johnson Temperament Analysis (T-JTA®) in neurodiverse youth. Psychology Research and Practice, 4(2).
[19]Lam, B., Low, A., Wong, M., & Chau, T. (2026). Clinical effectiveness of Rope Therapy for emotional regulation and task engagement in youth with neurodevelopmental conditions: A practice-based evidence study. Archives of Clinical Trials, 6(1), 013.
[20]Lehrer, P. M., & Gevirtz, R. (2014). Heart rate variability biofeedback: How and why does it work? Frontiers in Psychology, 5, 756.
[21]Lehrer, P. M., Vaschillo, E., & Vaschillo, B. (2000). Resonant frequency biofeedback training to increase cardiac variability: Rationale and manual for training. Applied Psychophysiology and Biofeedback, 25(3), 177–191.
[22]Levine, P. A. (1997). Waking the tiger: Healing trauma. North Atlantic Books.
[23]Lloyd, C., King, R., & Chenoweth, L. (2002). Social work, stress and burnout: A review. Journal of Mental Health, 11(3), 255–265.
[24]Lopez, C., & Blanke, O. (2011). The thalamocortical vestibular system in animals and humans. Brain Research Reviews, 67(1–2), 119–146.
[25]Low, A., & McCraty, R. (2018). Heart rate variability: New perspectives on assessment of stress and health risk at the workplace. Heart and Mind, 2(1), 16–27.
[26]Low, A., & Wong, I. (2018). Case study: Adopting heart rate variability biofeedback to decrease workplace stress. Heart and Mind, 2(2), 51–56.
[27]McCraty, R., & Zayas, M. A. (2014). Cardiac coherence, self-regulation, autonomic stability, and psychosocial well-being. Frontiers in Psychology, 5, 1090.
[28]Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the body: A sensorimotor approach to psychotherapy. W. W. Norton.
[29]Porges, S. W. (2007). The polyvagal perspective. Biological Psychology, 74(2), 116–143.
[30]Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of emotions, attachment, communication, and self-regulation. W. W. Norton.
[31]Rosenthal, R. (1991). Meta-analytic procedures for social research (Rev. ed.). Sage.
[32]Schnurr, P. P., & Green, B. L. (Eds.). (2004). Trauma and health: Physical health consequences of exposure to extreme stress. American Psychological Association.
[33]Shaffer, F., & Ginsberg, J. P. (2017). An overview of heart rate variability metrics and norms. Frontiers in Public Health, 5, 258.
[34]Substance Abuse and Mental Health Services Administration (SAMHSA). (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach (HHS Publication No. SMA 14-4884). Substance Abuse and Mental Health Services Administration.
[35]Tang, C. S. K. (2009). Working stress, mental health, and coping resources of professional social workers in Hong Kong. International Social Work, 52(6), 793–807.
[36]Thayer, J. F., & Lane, R. D. (2009). Claude Bernard and the heart-brain connection: Further elaboration of a model of neurovisceral integration. Neuroscience & Biobehavioral Reviews, 33(2), 81–88.
[37]Thayer, J. F., Åhs, F., Fredrikson, M., Sollers, J. J., & Wager, T. D. (2012). A meta-analysis of heart rate variability and neuroimaging studies: Implications for heart rate variability as a marker of stress and health. Neuroscience & Biobehavioral Reviews, 36(2), 747–756.
[38]Tsai, W. (2017). Cultural differences in emotion expression and suppression: Implications for health and well-being. Cultural Diversity and Ethnic Minority Psychology, 23(3), 405–418.
[39]Umetani, K., Singer, D. H., McCraty, R., & Atkinson, M. (1998). Twenty-four hour time domain heart rate variability and heart rate: Relations to age and gender over nine decades. Journal of the American College of Cardiology, 31(3), 593–601.
[40]van der Kolk, B. A. (2014). The body keeps the score: Brain, mind, and body in the healing of trauma. Viking.
[41]Wagaman, M. A., Geiger, J. M., Shockley, C., & Segal, E. A. (2015). The role of empathy in burnout, compassion satisfaction, and secondary traumatic stress among social workers. Social Work, 60(3), 201–209.
[42]Yates, B. J., & Bronstein, A. M. (2005). The effects of vestibular system lesions on autonomic regulation: Observations, mechanisms, and clinical implications. Journal of Vestibular Research, 15(3), 119–129.
Copyright © 2026 Dr. Benny W. L. Lam, Dr. Adrian Low Eng Ken, Mr. Tony Chau, Mr. Marco Wong
Publishing time:2026-07-22
This work is licensed under a Creative Commons Attribution 4.0 International License